Long-stay patients in state psychiatric hospitals at the end of the 20th century

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Female; History, 20th Century; Hospitalization; Hospitals, Psychiatric; Hospitals, State; Humans; Length of Stay; Male; Mental Disorders; Mental Health Services; data; United States


Life Sciences | Medicine and Health Sciences | Psychiatry


OBJECTIVES: The purpose of this study was to assess the characteristics of long-stay patients in contemporary state psychiatric hospitals and to identify factors representing possible barriers to alternative placements for these patients.

METHODS: All patients in inpatient units of the Massachusetts Department of Mental Health who had been hospitalized for at least three years as of April 1, 1999, were assessed by their treatment teams with a standardized data collection instrument. Domains assessed included medical problems, need for nursing care, psychiatric diagnosis, and history of problematic behaviors.

RESULTS: The 330 individuals identified as long-stay patients had an array of medical problems and nursing care needs that likely would have been manageable in other long-term-care settings. A total of 276 patients had at least one significant medical problem. However, some patients exhibited behavioral problems that might have complicated such placements, especially when behavioral problems co-occurred with the need for medical supervision. A total of 228 patients had exhibited a significant problematic behavior in the previous 30 days.

CONCLUSIONS: Although the number of long-stay patients in state psychiatric hospitals declined dramatically during the second half of the 20th century, a small group of patients still requires care in this setting. State psychiatric hospitals continue to occupy a significant niche in the mental health system.


Psychiatr Serv. 2001 Aug;52(8):1051-6.

Journal/Book/Conference Title

Psychiatric services (Washington, D.C.)

Related Resources

Link to Article in PubMed

PubMed ID